NYC Cardiac Procedures Have Low Mortality Rates

Ruzanna Harutyunyan's picture

New York hospitals continue to have low mortality rates associated with cardiac surgery and percutaneous coronary interventions (angioplasty), according to two reports issued today by the State Health Department.

The reports examine outcomes in adult cardiac surgery and angioplasty procedures conducted at hospitals in the state during the period 2004 through 2006.

"New Yorkers can be assured that the quality of care they receive at our hospitals is first-rate, as demonstrated by our world-class cardiac assessment program," said State Health Commissioner Richard F. Daines, M.D. "Our reports continue to show the high-quality care that cardiac surgery and angioplasty patients receive in New York State. Under Governor Paterson's leadership, the Department will continue to work with hospitals and other providers to improve our cardiac care by ensuring better access and improved outcomes, further enhancing patient safety and quality care for all New Yorkers."

The Adult Cardiac Surgery Report includes information on coronary artery bypass graft surgery, valve surgery, and combined bypass/valve surgery at 39 hospitals in New York State where these procedures are performed. The Percutaneous Coronary Interventions Report provides data on percutaneous coronary interventions (PCI), or procedures used to clear blocked coronary arteries. These procedures are commonly referred to as "angioplasty" or "coronary stenting." The report presents the outcomes of 167,752 patients undergoing PCI at 51 hospitals in New York that perform this procedure.

Among the major findings of the reports:

Adult Cardiac Surgery

* In 2006, 11,929 cardiac bypass surgeries were performed with a combined in-hospital and 30-day mortality rate of 1.92 percent – down slightly from 2.02 percent in 2005.

* During 2004-2006, 20,969 patients underwent valve or a combination of valve and bypass surgery. The statewide in-hospital and 30-day mortality rate for this group was 5.83 percent.


Percutaneous Coronary Interventions

* In 2006, the number of PCI procedures increased to 57,944 from 56,058 in 2005. The 2006 combined in-hospital/30-day mortality rate was 0.87 percent.

* 2006 non-emergency PCI procedures (procedures performed on patients who are not in shock, do not have very low blood pressure, and who have not had a heart attack within 24 hours before the procedure) increased to 51,606, from 49,692 in 2005. The 2006 combined in-hospital and 30-day mortality rate for non-emergency patients was 0.63 percent.

The mortalities include any death occurring in the same hospital stay in which a patient underwent cardiac surgery or angioplasty, and any death that occurs after hospital discharge but within 30 days of the procedure. Results are reported for hospitals and individual physicians performing the procedures.

The primary sources of data for the reports are the New York State Cardiac Surgery Reporting System and the New York State Percutaneous Coronary Interventions Reporting System. These clinical registries gather information on each patient's demographic and clinical characteristics, the procedure performed, and the outcome. As part of the reporting system, hospitals have the ability to track their own data and compare their experience to statewide outcomes.

For the first time, both reports exclude data collected on patients meeting the Cardiac Data System definition of pre-operative cardiogenic shock – a condition associated with very low blood pressure, which puts patients at high risk when undergoing cardiac surgery or PCI. Patients with this condition are no longer included in data analysis and in publicly released reports to make certain that physicians perform these potentially life saving procedures whenever appropriate and medically necessary. Due to this change, the 2004-2006 mortality rate data collected for both reports cannot be compared to data presented in previous public reports.

Data collection and analysis are conducted under the guidance of the New York State Cardiac Advisory Committee, comprised of nationally prominent cardiologists, cardiac surgeons and other medical specialists.

"New York State has taken a leadership role in setting standards for cardiac services, monitoring outcomes, and sharing performance data with patients, hospitals and physicians," said Dr. Daines. "Hospitals and doctors involved in the care of cardiac patients have worked in cooperation with the State Health Department and its Cardiac Advisory Committee to compile accurate and meaningful data for use in enhancing quality of care."

New York was the first state in the nation to make publicly available the information contained in these reports and has been releasing cardiac surgery reports for more than 15 years.

Dr. Edward Hannan, Ph.D., Associate Dean for Research at the University at Albany School of Public Health and a consultant to New York's Cardiac Advisory Committee, said, "PCIs are among the most common procedures performed in the United States. The State Health Department's policy of releasing risk-adjusted PCI outcomes to patients, hospitals, and physicians is enhancing the quality with which PCI is performed in the state, serving as a model for the federal government and other state governments in monitoring and improving outcomes of care."